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Tao Jie'an said: Whenever there are symptoms of headache and aversion to cold, it is Taiyang Cold Damage (Shanghan); if these symptoms are absent, it is not. Why? Because Cold Damage causes aversion to cold, while food stagnation causes aversion to food; this is the natural principle. However, in winter, aversion to cold is particularly severe. This is because winter is the time for true Cold Damage; the weather is freezing and condensed, wind-cold is fierce, and those who are exposed will experience severe aversion to cold. In other seasons, although there may be some aversion to cold, it is mild and not as severe as in winter.

In winter, the climate is cold, and the Couli (pores and interstitial spaces) are tight and dense; therefore, acrid-sweet-warm herbs are indispensable. Thus, Guizhi Tang (Cinnamon Twig Decoction) and similar formulas are used for treatment. However, Wind pathogen and Cold pathogen often accompany each other. When Cold damages Ying (Nutritive Qi), symptoms include headache, aversion to cold, floating-tight pulse, and absence of sweating; in this case, Mahuang Tang (Ephedra Decoction) should be used to open the Couli and disperse the pathogen. Recovery occurs once sweating ensues. When Wind damages Wei (Defensive Qi), symptoms include headache, aversion to wind, floating-slow pulse, and spontaneous sweating; in this case, Guizhi Tang (Cinnamon Twig Decoction) should be used to fill the Couli and disperse the pathogen. Recovery occurs once sweating stops. The Classic states: "Acrid and sweet substances that disperse belong to Yang." This refers to the aforementioned scenarios.

However, when both Ying and Wei are damaged, neither of these two formulas is sufficient; Da Qinglong Tang (Major Blue Green Dragon Decoction) must be used. Yet, this formula is too harsh, so there are alternatives. If the season is not winter, but there are symptoms of aversion to cold and headache, acrid-cool agents should be used to unblock the exterior and interior and harmonize the body, leading to recovery. Using acrid-warm medicines like Guizhi Tang indiscriminately would be fatal. Question: What are acrid-cool agents? Answer: Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction) is one such agent, which can also substitute for Da Qinglong Tang, making it very safe. Alas! One decoction can replace three dangerous formulas, turning peril into safety, truly miraculous.

Beyond this, Shaoyang (Lesser Yang) and Yangming (Yang Brightness) disorders lie between the exterior and interior, within the muscle layer. The pulse is neither floating nor sunken. Externally, Yangming manifestations include eye pain, nasal dryness, and insomnia; the pulse resembles a flooding-long pulse. These are treated with Gegen Jiemo Tang (Kudzu Muscle-Releasing Decoction) or Shengma Tang (Cimicifuga Decoction). Shaoyang manifestations include hypochondriac pain and deafness, with a wiry-rapid pulse; these are harmonized using Xiaochaihu Tang (Minor Bupleurum Decoction) with modifications. The base formula has specific modification rules. Disorders of these two meridians are treated according to the "Middle" principle rather than the Root or Branch. I often use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Gegen (Kudzu Root) and Shaoyao (Peony Root) to treat simultaneous Shaoyang and Yangming diseases, which is as easy as picking up grass from the ground.

If the condition persists without improvement, it transmits to the root of Yangming, entering the interior, and becomes an Interior Excess-Heat syndrome. All external symptoms disappear, meaning no headache or aversion to cold; the pulse is deep, solid, and not floating; there is delirious speech, aversion to heat, constipation for six to seven days, dry mouth and throat with thirst. Mild cases are treated with Daxiehu Tang (Major Bupleurum Decoction); severe cases select among the Three Chengqi Decoctions. One might ask: Since the pathogen has entered the interior forming excess, why not simply use Kuhan (bitter-cold) drugs like Dahuang (Rhubarb) to purge downwards? Why is the prescription complex? I reply: The transmission sources vary, so treatments differ.

If the pathogen injures all three Jiao (Upper, Middle, Lower), presenting with fullness (Pi), distension (Man), dryness (Zao), and solidity (Shi), Dachengqi Tang (Major Order the Qi Decoction) is appropriate. Houpo (Magnolia Bark) is bitter-warm to remove Pi accumulation; Zhishi (Immature Bitter Orange) is bitter-cold to drain Man distension; Mangxiao (Mirabilite) is salty-cold to moisten Zao dryness and soften hardness; Dahuang (Rhubarb) is bitter-cold to drain Shi solidity and clear heat. Only then does the disease resolve. If the pathogen is in the Middle Jiao, presenting with dryness, solidity, and hardness, Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) is used. Gancao (Licorice) harmonizes the middle; Mangxiao softens hardness and moistens dryness; Dahuang drains solidity. Zhishi and Houpo are omitted to avoid damaging the ethereal, light, and clear Yuanqi (Original Qi) of the Upper Jiao. Hence the name "Regulate the Stomach." If the Upper Jiao is injured, resulting in Pi and Shi, Xiao Chengqi Tang (Minor Order the Qi Decoction) is used. Zhishi and Houpo remove Pi; Dahuang drains Shi; Mangxiao is omitted to avoid injuring the True Yin of the Blood aspect, preserving the root.

As for Daxiehu Tang (Major Bupleurum Decoction), it is used when exterior pathogens remain alongside interior syndromes requiring urgent purgation, thereby unblocking the exterior and interior while treating gently. It is contraindicated for the elderly and those with dual deficiency of Qi and Blood. Regarding San Yang (Three Yang) pathogens residing in the interior during the three seasons (Spring, Summer, Autumn): if there is no headache or aversion to cold, but instead thirst, this is Wenbing (Warm Disease). Shubing (Summerheat Disease) is similar but more febrile. Treatment favors Xiaochaihu Tang (Minor Bupleurum Decoction), as it treats Warm Disease in Spring, Summerheat in Summer, and moistens dryness in Autumn. Additionally, Gegen Tang (Kudzu Decoction), Shengma Tang (Cimicifuga Decoction), Jiemo Tang (Muscle-Releasing Decoction), and Baidu San (Detoxify Poison Powder) are suitable. For summerheat with thirst, Chaihu Shigao Tang (Bupleurum and Gypsum Decoction) or Renshen Baibu Tang (Ginseng White Tiger Decoction) are selected based on the severity of thirst, proving effective. The Classic states: "Fever without aversion to cold accompanied by thirst indicates Warm Disease." Yin syndromes have separate methods and are not covered here.